Simultaneous Use of Laparoscopy and Endoscopy for Minimally Invasive Resection of Gastric Subepithelial Masses — Analysis of 93 Interventions

Wilhelm, Dirk; Delius, Stefan von; Burian, Maria; Schneider, Armin; Frimberger, E; Meining, Alexander; Feußner, H.

doi:10.1007/s00268-008-9492-1

Cited by 101 publications

(53 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Endoscopic resection of small GISTs is more controversial due to the risks of positive margins, tumor spillage and intact specimen retrieval [9,15,18,29] . During laparoscopic partial gastrectomy for GIST of the stomach, it is important to avoid an excessive surgical resection of the gastric wall as this can cause a deformity of the stomach [34][35][36] . Laparoscopic and endoscopic cooperative surgery (LECS) is a procedure which enables tumor resection with minimal surgical margin [35][36][37][38] .…”

Section: Role Of Laparoscopymentioning

confidence: 99%

“…Laparoscopic and endoscopic cooperative surgery (LECS) is a procedure which enables tumor resection with minimal surgical margin [35][36][37][38] . The LECS procedure involves seromuscular resection by laparoscopy with endoscopic dissection for the mucosal to submucosal layers, making it possible to standardize gastric submucosal tumor resection independent of tumor location, such as in the vicinity of the esophagogastric junction or pyloric ring [34][35][36][37][38] . …”

Section: Role Of Laparoscopymentioning

confidence: 99%

See 1 more Smart Citation

A gist of gastrointestinal stromal tumors: A review

Rammohan¹,

Sathyanesan²,

Rajendran³

et al. 2012

WJGO

154

193

View full text Add to dashboard Cite

enchymal tumors. Both traditional and minimally invasive surgery are used to remove these tumors with minimal morbidity and excellent perioperative outcomes. The revolutionary use of specific, molecularlytargeted therapies, such as imatinib mesylate, reduces the frequency of disease recurrence when used as an adjuvant following complete resection. Neoadjuvant treatment with these agents appears to stabilize disease in the majority of patients and may reduce the extent of surgical resection required for subsequent complete tumor removal. The important interplay between the molecular genetics of GIST and responses to targeted therapeutics serves as a model for the study of targeted therapies in other solid tumors. This review summarizes our current knowledge and recent advances regarding the histogenesis, pathology, molecular biology, the basis for the novel targeted cancer therapy and current evidence based management of these unique tumors. AbstractGastrointestinal stromal tumors (GISTs)

show abstract

Section: Role Of Laparoscopymentioning

confidence: 99%

Section: Role Of Laparoscopymentioning

confidence: 99%

A gist of gastrointestinal stromal tumors: A review

Rammohan¹,

Sathyanesan²,

Rajendran³

et al. 2012

WJGO

154

193

View full text Add to dashboard Cite

show abstract

“…Current guidelines from expert panels in Europe 27 and the USA 28 suggest that laparoscopic resection for gastric GISTs should be restricted to tumours smaller than 2 cm that are intramural and so have a low risk of rupture and subsequent peritoneal seeding. These small, submucosal GISTs may benefit from a dual laparoscopic-endoscopic approach, intraoperative endoscopy (with or without endoscopic ultrasonography) facilitating exact tumour localization and circumferential dissection of both mucosal and submucosal layers around the lesion 29,30 .…”

Section: Stomachmentioning

confidence: 99%

Surgical management of gastrointestinal stromal tumours

Gervaz

Huber

Morel

2009

British Journal of Surgery

101

View full text Add to dashboard Cite

Background: Over the past decade, gastrointestinal stromal tumours (GISTs) have served as a model for the application of tyrosine kinase inhibitors in the treatment of solid neoplasms. Operative and medical management of GISTs is rapidly evolving, but current guidelines appear restricted to basic non-organ-specific recommendations.Methods: A PubMed search was made of the English literature from 1998 to 2008 for references containing the terms 'gastrointestinal stromal tumours' and 'surgery'. This paper reviews the various operative strategies so far reported for GISTs within the digestive tract.Results: Many original procedures tailored to the specific characteristics of these rare sarcomas have been reported. GISTs exhibit distinct features, in particular an absence of metastases within locoregional lymph nodes. Operations requiring extended lymph node dissection, typically designed for adenocarcinomas, such as gastrectomy with extended lymph node dissection, Whipple's procedure and total mesorectum excision, are inappropriate for treating GISTs originating from the stomach, duodenum and rectum respectively.

show abstract

“…Endoscopic ultrasonography (EUS) can provide information about the size, layer of origin, margins, and echogenicity of SMTs, but multiple biopsies, either through conventional endoscopy or EUS guided, often fail to distinguish between benign and malignant disease [6]. The treatment of choice has, until now, consisted of surgical resection with an open or laparoscopic approach [7]. However, this technique is overly invasive for lesions with a diameter\2 cm and with a low mitotic count (\5) as determined by the examination of microscopic high-power fields (HPFs) [8].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic submucosal dissection in the treatment of gastric submucosal tumors: results from a retrospective cohort study

et al. 2012

View full text Add to dashboard Cite

Background A submucosal tumor (SMT) of the stomach, which is an occasional finding during routine upper gastrointestinal endoscopy, may pose diagnostic and therapeutic challenges. Methods To assess whether endoscopic submucosal dissection (ESD) is a feasible approach to definitively cure SMTs, the authors performed a retrospective cohort study with two endoscopic italian centers.Results The study consisted of 20 patients with SMTs who underwent ESD. The patients underwent ESD and were followed up by endoscopy. We analyzed complete resection rate, frequency of complications, and survival. The overall rate of R0 resection was 90 % (18/20), with two endoscopic failures, one for a submucosal tumor and one for a neoplasm deeply infiltrating the proper muscle layer. The median procedure time was 119.1 min (range 40-240 min). The median size of the resected specimens was 29 mm (range 15-60 mm). Perforation occurred in 3 patients; all were treated conservatively. There were no cases of severe bleeding. Based on histopathological findings, 6 cases of ectopic pancreas, 1 of ectopic spleen, 3 of leiomyoma, and 10 of gastrointestinal stromal tumor (GIST) were diagnosed. Complete resection was obtained in all GIST cases. Among the 10 GIST cases treated by ESD, no death occurred: the 5-year disease-specific survival rate was 100 %. Conclusions The high success rate of 90 % and the low incidence of complications should indicate ESD is the correct diagnostic and definitive treatment in selected patients.

show abstract

Simultaneous Use of Laparoscopy and Endoscopy for Minimally Invasive Resection of Gastric Subepithelial Masses — Analysis of 93 Interventions

Cited by 101 publications

References 50 publications

A gist of gastrointestinal stromal tumors: A review

A gist of gastrointestinal stromal tumors: A review

Surgical management of gastrointestinal stromal tumours

Endoscopic submucosal dissection in the treatment of gastric submucosal tumors: results from a retrospective cohort study

Contact Info

Product

Resources

About